[关键词]
[摘要]
目的 探讨加味溃结灵治疗脾虚湿瘀型溃疡性结肠炎的临床疗效和机制。方法 采用随机、多中心、对 照临床试验设计,评估加味溃结灵联合美沙拉嗪肠溶片治疗轻中度活动期溃疡性结肠炎脾虚湿瘀证的临床疗 效,并利用网络药理学、分子对接技术探讨其作用机制。结果 临床研究表明,加味溃结灵联合美沙拉嗪在改 良 Mayo 评分、炎症性肠病精简版问卷(SIBDQ)评分、炎症性肠病简明健康量表(SHS)评分、Bristol 粪便性状量 表评分等方面优于单用美沙拉嗪(P<0.05)。网络药理学及分子对接分析揭示加味溃结灵主要活性成分通过作 用于 AKT1、STAT3、EGFR 等核心靶点,干预 PI3K/Akt 通路、JAK-STAT 信号通路,对溃疡性结肠炎发挥治 疗作用。结论 中西医结合治疗溃疡性结肠炎较单用西药更能改善患者症状,加味溃结灵通过多成分、多靶 点、多通路的作用机制,为溃疡性结肠炎治疗提供了新的策略和思路。
[Key word]
[Abstract]
Objective To investigate the clinical efficacy and mechanism of Modified Kuijieling in treating ulcerative colitis (UC) of spleen deficiency and dampness-stasis syndrome type. Methods A randomized, multicenter, controlled clinical trial was conducted to evaluate the clinical efficacy of Modified Kuijieling combined with Mesalazine Enteric-Coated Tablets in patients with mild-to-moderate active UC of spleen deficiency and dampness-stasis type. Network pharmacology and molecular docking techniques were employed to explore its mechanism of action. Results Clinical studies demonstrated that Modified Kuijieling combined with mesalazine was superior to mesalazine alone in terms of modified Mayo score,Short Inflammatory Bowel Disease Questionnaire (SIBDQ) score,Simple Health Scale (SHS) for inflammatory bowel disease, Bristol Stool Form Scale score, and other indicators (P<0.05). Network pharmacology and molecular docking analyses revealed that the main active components of Modified Kuijieling exert therapeutic effects on UC by acting on core targets such as AKT1,STAT3,and EGFR,and intervening in the PI3K/ Akt pathway and JAK-STAT signaling pathway. Conclusion Integrated traditional Chinese and western medicine treatment for UC provides better symptom improvement than qestern medicine alone. Modified Kuijieling offers a new strategy and approach for UC treatment through its multi-component,multi-target,and multi-pathway mechanism of action.
[中图分类号]
R285.6
[基金项目]
国家自然科学基金项目(8207140963);广州中医药大学创新强院工程项目(2019IIT25);2023年广州市重点研发计划农业和社会发展 科技专题(SL2022B03J00104);广东省普通高校重点领域专项(2022ZDZX2012);广州中医药大学“双一流”学科高质量“筑峰造尖”行动计划“固本” 工程基金(GZY2025GB0423)。